Amdur Richard L, Mukherjee Monica, Go Alan, Barrows Ian R, Ramezani Ali, Shoji Jun, Reilly Muredach P, Gnanaraj Joseph, Deo Raj, Roas Sylvia, Keane Martin, Master Steve, Teal Valerie, Soliman Elsayed Z, Yang Peter, Feldman Harold, Kusek John W, Tracy Cynthia M, Raj Dominic S
Biostatistics core, George Washington University Medical Faculty Associates, Washington, DC, United States of America.
George Washington University School of Medicine, Washington, DC, United States of America.
PLoS One. 2016 Feb 3;11(2):e0148189. doi: 10.1371/journal.pone.0148189. eCollection 2016.
Atrial fibrillation (AF) is the most common sustained arrhythmia in patients with chronic kidney disease (CKD). In this study, we examined the association between inflammation and AF in 3,762 adults with CKD, enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study. AF was determined at baseline by self-report and electrocardiogram (ECG). Plasma concentrations of interleukin(IL)-1, IL-1 Receptor antagonist, IL-6, tumor necrosis factor (TNF)-α, transforming growth factor-β, high sensitivity C-Reactive protein, and fibrinogen, measured at baseline. At baseline, 642 subjects had history of AF, but only 44 had AF in ECG recording. During a mean follow-up of 3.7 years, 108 subjects developed new-onset AF. There was no significant association between inflammatory biomarkers and past history of AF. After adjustment for demographic characteristics, comorbid conditions, laboratory values, echocardiographic variables, and medication use, plasma IL-6 level was significantly associated with presence of AF at baseline (Odds ratio [OR], 1.61; 95% confidence interval [CI], 1.21 to 2.14; P = 0.001) and new-onset AF (OR, 1.25; 95% CI, 1.02 to 1.53; P = 0.03). To summarize, plasma IL-6 level is an independent and consistent predictor of AF in patients with CKD.
心房颤动（AF）是慢性肾脏病（CKD）患者中最常见的持续性心律失常。在本研究中，我们在纳入慢性肾功能不全队列（CRIC）研究的3762例成年CKD患者中，研究了炎症与AF之间的关联。通过自我报告和心电图（ECG）在基线时确定AF。在基线时测量血浆白细胞介素（IL）-1、IL-1受体拮抗剂、IL-6、肿瘤坏死因子（TNF）-α、转化生长因子-β、高敏C反应蛋白和纤维蛋白原的浓度。基线时，642名受试者有AF病史，但心电图记录中只有44人有AF。在平均3.7年的随访期间，108名受试者出现新发AF。炎症生物标志物与AF既往史之间无显著关联。在调整人口统计学特征、合并症、实验室值、超声心动图变量和药物使用后，血浆IL-6水平与基线时AF的存在显著相关（优势比[OR]，1.61；95%置信区间[CI]，1.21至2.14；P = 0.001）以及新发AF（OR，1.25；95%CI，1.02至1.53；P = 0.03）。总之，血浆IL-6水平是CKD患者AF的独立且一致的预测指标。
